Early revisions of the Femoro-Patella Vialla joint replacement

Abstract

The aim of this study was to review the early outcome of the Femoro-Patella Vialla (FPV) joint replacement. A total of 48 consecutive FPVs were implanted between December 2007 and June 2011. Case-note analysis was performed to evaluate the indications, operative histology, operative findings, post-operative complications and reasons for revision. The mean age of the patients was 63.3 years (48.2 to 81.0) and the mean follow-up was 25.0 months (6.1 to 48.9). Revision was performed in seven (14.6%) at a mean of 21.7 months, and there was one re-revision. Persistent pain was observed in three further patients who remain unrevised. The reasons for revision were pain due to progressive tibiofemoral disease in five, inflammatory arthritis in one, and patellar fracture following trauma in one. No failures were related to the implant or the technique. Trochlear dysplasia was associated with a significantly lower rate of revision (5.9% vs 35.7%, p = 0.017) and a lower incidence of revision or persistent pain (11.8% vs 42.9%, p = 0.045). Focal patellofemoral osteoarthritis secondary to trochlear dysplasia should be considered the best indication for patellofemoral replacement. Standardised radiological imaging, with MRI to exclude overt tibiofemoral disease should be part of the pre-operative assessment, especially for the non-dysplastic knee.

Patellofemoral arthroplasty: outcomes and factors associated with early progression of tibiofemoral arthritis

“…1 a, [11]. However, we are aware of only one other study that has documented less radiographic progression of tibiofemoral arthritis in patients with trochlear dysplasia undergoing modern PFA [14,20]. Despite evidence for progression of tibiofemoral arthritis in our cohort of patients without trochlear dysplasia, very few patients had required revision to TKA at mid-term follow-up.…”

Isolierter patellofemoraler Gelenkersatz

“…Häufig Eine Vielzahl von Autoren berichtet basierend auf Fallserien (Evidenzlevel 4) ihre Ergebnisse der PFG-Prothetik [1,2,6,7,10,14,20,21,25,26,[31][32][33]35]. Publikationen mit dem längsten verfüg-baren Follow-up beziehen sich auf die Richards-Prothese (Smith & Nephew).…”

“…Zu anderen Prothesenarten existieren entweder nur einzelne Berichte (Hermes, Ceraver; [14]), oder der jeweilige Prothesentyp wurde aufgrund des spezifischen Designs mit einem schlechten Outcome assoziiert und gilt heute als obsolet (Femoro-Patella Vialla, Wright [10,35]; Lubinus, Link [32]; LCS patellofemoral; Depuy [7]). In Zusammenschau der genannten Fallserien scheint der Erfolg somit stark vom jeweiligen Prothesendesign abhängig.…”

“…In Zusammenschau der genannten Fallserien scheint der Erfolg somit stark vom jeweiligen Prothesendesign abhängig. Mehrere Autoren berichteten [2,35], dass Patienten, bei welchen sich die PFG-Arthrose aufgrund einer Patellainstabilität (z. B. Trochleadysplasie) entwickelt hat, ein besseres Outcome einer PFG-Prothese haben.…”

(vi) Focal resurfacing implants in the knee and partial knee replacements

“…Their development has been blighted with failed devices. 27,28 The Avon PFJ replacement is the most implanted device in the UK. The designing surgeons have reported five-year MINI-SYMPOSIUM: SOFT TISSUE KNEE e CURRENT CONCEPTS ORTHOPAEDICS AND TRAUMA 29:1 survival of 95.8%, with improvement in the Oxford knee score from 18 out of 48 pre-operatively to 39 post-operatively.…”